Dagan O, Klein J, Bohn D, Koren G
Department of Critical Care, Hospital for Sick Children, Toronto, ON, Canada.
Crit Care Med. 1994 Jul;22(7):1099-101. doi: 10.1097/00003246-199407000-00008.
To study the effect of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics of morphine in infants.
A prospective, comparative study of morphine pharmacokinetics during and after ECMO.
The pediatric intensive care unit at a children's hospital.
Seven infants, aged 1 day to 12 months, requiring ECMO.
Infusion of morphine.
Steady-state concentrations of morphine were used to generate a morphine clearance rate. Plasma clearance rate of morphine increased from 0.574 +/- 0.3 L/kg/hr to 1.058 +/- 0.727 L/kg/hr after discontinuation of ECMO (p < .01). Two infants experienced a clinical picture consistent with opioid withdrawal.
Infants requiring morphine after ECMO may require higher dose rates to maintain adequate sedation.
